This document discusses quality assurance in healthcare. It defines quality assurance as activities that contribute to defining, designing, assessing, monitoring, and improving quality of care. Quality assurance aims to meet customer expectations and improve credibility. Approaches to quality assurance include licensure to ensure minimum qualifications, accreditation for continuous improvement strategies, and certification to recognize excellence. Models used to evaluate quality include Donabedian's structure-process-outcome model, the tracer model focusing on process and outcomes, and the sentinel method measuring incidents related to quality.

1. QUALITY ASSURANCE
Presented By:
Pratima Thakur
M.Sc. Nursing

2. Meaning of Quality
Quality is weighing – out between results and costs
to fulfill certain expectations in health care.

3. CONCEPT OF QUALITY ASSURANCE
“Quality assurance is a dynamic process through which nurses assume
accountability for quality of care they provide. It is planned and systematic
actions and programs that are designed to provide confidence that a product
or service will meet the customer expectations and that improve a company’s
credibility and enable them to compete better with others”.
(ISO 9000)

4. Definition of Quality Assurance
• “Quality assurance can be defined as all activities that contribute to
defining, designing, assessing, monitoring and improving the quality
of care.”
MARKER

5. DEFINITION…
Quality assurance is the process of achieving excellence in the
service rendered to every client.

6. Quality Improvement
Principles:
• - Knowledge of customer expectation needs.
• - Processes of customer supplier relationship.
• - Belief in people.
• - Statistical analysis.
• - Costs of poor quality.

7. Conditions in the work environment:
• - Employer involvement.
• - An environment that supports risk taking.
• - Team work.
• - Data collection and analysis skills.
• - Group interaction skills.
• - Tools to facilitate the improvement.

8. Framework for quality:
• Quality defined: Before the nurse manager and staff can measure
trends in nursing practice, they first must know the standards or
guidelines that define quality.
• Professional standards: They are authoritative statements used by the
profession in describing the responsibilities for which its practitioners
are accountable. (Peters 1995)
o Policies
o Job description
o Outcomes

9. MODELS OF QUALITY ASSURANCE: -
1) A System Model for implementation of unit Based Quality
assurance
2)American Nurses Association Model
3)ANA Quality Assurance Model

11. IDENTIFY VALUE
IDENTIFY STANDARDS
MEASUREMENT OF QUALITY
MAKING JUDGEMENTS
NECESSARY ACTIONS
RE-EVALUATION

12. FACTORS AFFECTING QUALITY IN NURSING CARE
• Lack of resources
• Lack of manpower
• Improper maintenance
• Absence of strong accreditation laws

13. • Lack of awareness of malpractice litigation
• Lack of incident review reports
• Lack of good hospital information system
• Lack of nursing care records

14. DEVELOPMENT OF A QUALITY ASSURANCE
PROGRAM
• Foster Commitment Quality
• Conduct a Preliminary Review of Quality
• Develop the Purpose and Vision for the Quality Assurance Effort
• Determine level and scope of initial Quality Assurance Activities
• Assign responsibility for Quality Assurance

15. APPROACHES FOR QUALITY
ASSURANCE
GENERALAPPROACHES
SPECIFIC APPROACHES

16. GENERAL APPROACH
Done by external evaluation systems or regulatory bodies
Types are…..
• Licensure
• Accreditation
• Certification

17. LICENSURE
• Ensures the minimum
legal requirement or
qualifications for a
health care
professionals and for
organisations.
• It defines scopes and
limits of practice.
• Licensure of nursing is
mandated by law in
1903.

18. ACCREDITATION
• Accreditation focuses on continuous
improvement strategies, achievements of
optimal quality standards and ongoing
education.
• Done with the help of professional standard
review organizations.
(JCAHO,ISO,NCQA..)
• Certificate regarding quality was provided.

19. JCAHO’S 10 STEPS
FOR ACCREDITATION
• Establish responsibility and
accountabilty for program
• Define the scope of service of a
chemical area
• Define key aspects of service of
that chemical area
• Develop quality indicators to
monitor the system
• Establish a threshold for evaluation

20. • 6. Collect and analyse data from monitoring activities.
• 7. Evaluate results of monitoring activities to determine the
need for change in practice.
• 8. Resolve problems through development of action plans.
• 9. Revaluate to determine if the plan was successful.
• 10. Communicate Q.I results to the organization.

21. CERTIFICATION
• Certification is the voluntary practice of
validating that an individual nurse has got
minimum standards of nursing
competence in advanced practice areas.
• Certification recognizes excellence in
nursing practice.
• Certification is usually by non-
governmental organization.

22. Specific Approaches
• Peer review committee
• The audit Process
• Utilization Review

23. Three major models have been used to evaluate
quality
• Donabedian’s model
• Tracer model
• The sentinel model

24. Donabedian’s model:
STRUCTURE PROCESS OUTCOME

25. TRACER METHOD
FOCUS ON PROCESS AND OUTCOME ONLY

26. Sentinel Method
Measures occurrence of incidents which are related to
quality of care provided